Beta-hydroxybutyrate in milk as screening test for subclinical ketosis in dairy cows.

Ketosis is a very frequent metabolic disease in dairy cows, resulting in lower milk production, impaired fertility and increased frequency of other diseases. The course of the disease is often subclinical, so early detection is very important. The aim of the study was to investigate the relation between the concentration of beta-hydroxybutyrate in blood and milk and to determine the cut-off value in milk for detection of subclinical ketosis. The study included 94 cows, which were in the first third of lactation. Beta-hydroxybutyrate (BHB) concentrations were measured in blood and milk serum using a biochemical analyser. The average concentration of BHB in the blood serum samples was 1.14 mmol/L while in the milk it was about ten times lower at 0.117 mmol/L. A statistically significant positive correlation between the concentration of BHB in blood and milk (r=0.705, p<0.001) was found. In cows with BHB in blood below 2.0 mmol/L a stronger correlation between blood and milk BHB was established (r=0.658, p<0.001) than in cows with blood BHB above 2.0 mmol/L (r=-0.292, p=0.206). Therefore, BHB in milk is a very suitable indicator in the diagnosis of subclinical ketosis as there is a good correlation between BHB in the blood and milk of cows with subclinical ketosis. The cut-off concentration of BHB in milk set at ≥0.080 mmol/L (AUC=0.91±0.03; p<0.001) is a significant indicator for subclinical ketosis in dairy cows. The sensitivity of the test was 94% and specificity 74%. Beta-hydroxybutyrate in milk is a good indicator of subclinical ketosis in dairy cows and can be measured accurately with a biochemical analyser.

[Modern treatment of keloids]. / Savremeno lecenje keloida.

Keloids are a benign proliferative growth of dermal fibrous tissue, usually resulting from an excessive tissue response to skin trauma or disease in predisposed individuals. The basic cause is unknown. Hypertrophic scars are similar lesions but they will, in time, show some degree of resolution. These lesions can be aesthetically disfiguring and cause functional disturbances. This paper reviews current knowledge of the treatment modalities for keloids and hypertrophic scars. Most physicians emphasize the importance of prevention. No single therapeutic modality is the best. Current various treatment options of keloids and hypertrophic scars are: surgical treatment, radiation, medicamentous treatment, treatment by mechanical pressure, and laser therapy, each alone and in various combinations. The published recurrence rates for keloid treatments vary widely, although they are the lowest for the combination of surgery and radiation, but other measures may be useful. Some keloids and hypertrophic scars may respond to intralesional triamcinolone and verapamil, but results were significantly better in early lesions. Clinical trials of intralesional administration of gamma-interferon, as well as topical application of retinoids have caused reductions in keloids. Pressure treatment is widely accepted. Laser therapy which selectively injures cutaneous microvessels without inducing scars may be successfully used in the treatment of keloids and hypertrophic scars.